Babatasi G, Théron J, Massetti M, Gérard J L, Grollier G, Khayat A
Département de Chirurgie cardiovasculaire et thoracique, CHU Caen-Côte de Nacre.
Presse Med. 1996 Nov 9;25(34):1623-6.
There is debate over the therapeutic strategy in patients with lesions of both the coronary arteries and the carotid arteries. Improvement in angioplasty techniques for the carotid artery would be a minimally invasive alternative.
Between January 1993 and June 1995, 12 patients who underwent endoluminal angioplasty of the carotid artery before coronary bypass surgery (mean 17.9 days before) were included in the study. Mean age was 70 +/- 3.2 years. The carotid lesions were asymptomatic in all patients who had stable angina.
The mean number of bypasses was 2.9 per patient. Five patients had a contralateral stenosis of the internal carotid artery. Angioplasty was performed under cerebral protection using a three way coaxial catheter. A Strecker stent was required in 8 cases. One patient presented transient hemianopsia. All patients were seen again at 4 months for an angiogram then at 6 months for a Doppler examination. One patient needed complete redilatation with a stent and one other required dilatation of the stent.
Endoluminal angioplasty of the carotid arteries gave encouraging results in this high-risk population (underlying disease, age, bilateral carotid lesions, arterial coronary grafts). This technique should be used more widely for patients with severe multiple arterial lesions.
对于同时患有冠状动脉和颈动脉病变的患者，治疗策略存在争议。颈动脉血管成形术技术的改进将是一种微创替代方案。
1993年1月至1995年6月，12例在冠状动脉搭桥手术前（平均提前17.9天）接受颈动脉腔内血管成形术的患者纳入本研究。平均年龄为70±3.2岁。所有患有稳定型心绞痛的患者的颈动脉病变均无症状。
每位患者平均搭桥次数为2.9次。5例患者存在对侧颈内动脉狭窄。血管成形术在脑保护下使用三通同轴导管进行。8例患者需要使用施特雷克支架。1例患者出现短暂性偏盲。所有患者在4个月时再次进行血管造影检查，6个月时进行多普勒检查。1例患者需要用支架进行完全再扩张，另1例患者需要对支架进行扩张。
颈动脉腔内血管成形术在这一高危人群（基础疾病、年龄、双侧颈动脉病变、冠状动脉移植）中取得了令人鼓舞的结果。对于患有严重多发性动脉病变的患者，该技术应更广泛地应用。
